Nilden TUYGUN, Gülsüm İclal BAYHAN, Özge METİN TİMUR, Türkan TEKE AYDIN, Gönül TANIR, Fatma Nur ÖZ

Comparison of QuantiFERON-TB gold in-tube test with tuberculin skin test in children who had no contact with active tuberculosis case

Giriş: Bu çalışmada, Bacille Calmette- Guerin (BCG) aşısı bulunan çocuklarda latent tüberküloz infeksiyonu tanısında QuantiFERONTB gold in-tube test (QFT-GIT) ile tüberkülin cilt testini (TCT) karşılaştırmayı amaçladık. Materyal ve Metod: Çalışmada 2008-2011 yılları arasında bilinen tüberküloz temas öyküsü olmayan TCT pozitif 81 çocuk prospektif olarak değerlendirildi. Hastalar yaşlarına, TCT uygulanma nedenlerine, BCG aşı skar sayılarına ve TCT endurasyonuna göre gruplara ayrıldı. Ön-arka, yan akciğer grafileri ve gerek görülürse bilgisayarlı tomografi uygulandı. Bulgular: Çalışmada ortalama yaşı 94.8 ± 51.9 ay olan (6-193 ay arasında) 48 erkek (%59.3) ve 33 kız (%40.7) vardı. Altmış dokuz (%85.2) çocukta bir ve 12 (%14.8) çocukta iki BCG skarı mevcuttu. TCT endurasyon çapları 65 (%80.2) çocukta 15-19 mm ve 16 (%19.8) çocukta >= 20 mm idi. Çalışmaya alınan 12 (%14.8) hastada QFT-GIT pozitfliği bulundu. QFT-GIT pozitif hastalar üçlü antitüberküloz tedavi veya izoniazid (INH) ile tedavi edildi. Üç yıllık çalışma döneminde, antitüberküloz ilaçlarla tedavi edilmeyen çocuklar arasında tüberküloz hastalığı saptanmadı. Sonuç: BCG aşısının rutin olarak uygulandığı ülkelerde, özellikle düşük riskli çocuklarda, latent tüberküloz infeksiyonu yanlış pozitif tanı ve tedavisini dolayısıyla ilaç yan etkilerini azaltabileceğinden pozitif TCT sonuçlarının interferon-gama (IFN-?) tabanlı testlerle konfirme edilmesini önermekteyiz.

Aktif tüberkülozlu birey ile teması olmayan çocuklarda QuantiFERON-TB gold in-tube test ile tüberkülin cilt testinin karşılaştırılması

Introduction: In this study, we aimed to compare QuantiFERON-TB gold in-tube test (QFT-GIT) and tuberculin skin test (TST) as a diagnosis of latent tuberculosis infection in the children with Bacille Calmette-Guerin (BCG) vaccine. Materials and Methods: We evaluated 81 children in the study who have positive TST result without a known history of tuberculosis contact from 2008 to 2011 prospectively. Patients were separated into groups according to their ages, the reason of TST application, number of BCG vaccination scars and diameter of TST induration. Posteroanterior, lateral chest radiographies and computerized tomography, if necessary, were performed. Results: The study consists of 48 (59.3%) boys and 33 (40.7%) girls with a mean age of 94.8 ± 51.9 months (ranged from 6 to 193 months). Sixty nine (85.2%) children had one and 12 (14.8%) had two BCG vaccination scars. The TST induration diameters were 15-19 mm in 65 (80.2%) children and >= 20 mm in 16 (19.8%) children. QFT-GIT positivity was found in 12 (14.8%) of the evaluated patients. QFT-GIT positive patients were treatedwith triple anti-tuberculosis regime or isoniazid (INH). In three years period of study, there were no tuberculosis disease observed among the children who had not been treated with anti-tuberculosis drugs. Conclusion: As a result of the study it is suggested to confirm positive TST results with tests based on interferon-gamma (IFN-?) because it can reduce false positive diagnosis and treatment of latent tuberculosis infection, thus adverse reactions of drugs, in countries where BCG vaccination is routinely recommended especially for low risk children.

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